Erythrocytes and Hemoglobin of the Blood in Infancy and Childhood

Abstract

This paper presents a summary of hematologic data collected during the years 1932 to 1942. Some have been published previously in reports dealing particularly with problems of iron-deficiency anemia.1-5 At the time the studies were done plans were made for more complete statistical analysis of the assembled data, but various circumstances delayed the completion of that part of the project. The data are now presented in tables and charts designed to emphasize the sequence of changes in characteristics of the erythrocytes of infants and children at different ages and to demonstrate certain patterns of variability in those characteristics observed within different age groups.The data were derived from studies on 1735 samples of blood from infants and children selected at random, at ages from birth to 16 years. Of these, 1568 samples were from children born at full term, of single birth, and 167 samples were from twins, triplets, and prematurely born infants.Data from the latter were tabulated separately. These infants were treated as a single group because hematologically they appeared to follow similar patterns. For brevity these infants are referred to as the "premature group." Only a single sample was drawn from some individual infants, but from others samples were drawn serially at varying intervals while the infants were followed closely during periods of time from two to five years or longer. The ob¬ servations include samples from infants and children in the hospital, outpatient clinics, and orphanages, children both well and sick and from families of varying economic levels, but no patients with primary blood dyscrasias, and none who had ever received transfusions or any form of antianemic therapy. All were white, with known birth weight and birth order. Many studies on Negro infants were done but are not in¬ cluded in the present report because they did not represent a good sampling of the Negro population.We believe the subjects included in the present report comprised a representative sample of the white infant and child popu¬ lation of Cincinnati. Although most of the data were gathered 20 years ago, current observations in the hospital and outpatient clinic indicate that the incidence of iron deficiency disclosed by the indices here de¬ scribed remains essentially unchanged. Laboratory and Statistical Methods All measurements were made in the research laboratory. Blood samples were drawn by vein puncture and delivered into heparinized vials from which the blood was taken for the various tests. Hematocrit measurements were made in quadruplicate by the capillary tube method of Guest and Siler.7 For cell counting, duplicate dilutions were made in certified hemocytometer pipettes which were agitated mechanically. Double counting chambers were filled from each pipette, thus making quadruplicate counts for each blood sample. Hemoglobin was de¬ termined at first as carboxyhemoglobin by the Palmer method,8 later as oxyhemoglobin, in a photoelectric colorimeter. Both methods were standardized by determinations o...

The problem of iron deficiency anemia in preschool Negro children.

“…The prevalence cited in other reports has varied between these two extremes.6'9'10"14'15 It is generally accepted that the prevalence is considerably higher in Negro children" and in low income groups of all races. 16 One important fact has emerged from recent studies: diet, even Several recommendations seem warranted, based on the present information on the high prevalence of iron deficiency anemia that is found in the well-baby clinics of large cities: (1) routine laboratory testing should be performed by six months of age and again at 12 months of age-on those who do not receive prophylactic iron medication; (2) injections of iron by the intramuscular route should be considered for certain unusual cases; and (3) some form of prophylactic iron medication, preferably in the form of formulas fortified with iron to the level of 12 mg per quart, should be made available in the first nine months of life.…”

Health Needs of Migrant Children in a Kansas Day Care Program

“…The results ranged from a low of 7.5 grams in a 21-month-old to 12 grams in a 12year-old. All the hemoglobin values were from 1.2 to 4.2 grams below the average hemoglobin levels for comparable ages, as determined by Guest, and were from 1.5 to 3 grams below the relevant normal hemoglobin values listed by Smith in his survey of pediatric hematology (5,6).…”

“…An 11-year-old girl had severe chronic hoarseness. 5. A 9-year-old boy, with a coloboma of the iris and slight squint, had almost total loss of vision in one eye.…”

“…The parents of the children with possible need for glasses expressed no interest in the problem. 5. Two children never saw the local physician to whom they were referred, despite expressions of interest.…”

History of Pediatric Hematology Oncology

“…A.H. Washburn in Denver and G.M. Guest in Cincinnati performed studies of the blood values of normal infants and children (16,17). With definition of normal value, it became easier to identify specific hematologic diseases.…”